Introduction Increase in number of people in reproducible age
According to WHO, reproductive health means a total well being Increase in health facilities in all aspects of reproduction i.e., physical, emotional, social and Measures Taken by Government to Check Population behavioural. Motivate smaller families for using various contraceptive methods and by slogans “Hum do Hamare do”, in Problems and Strategies advertisements and posters. India was amongst first countries in the world to initiate action Urban couples adopting: “One child norm”. plans at a national level to attain total reproductive health such as Statutory raising of marriageable age: family planning programmes in 1951. Female-18 years Male-21 years Incentives given to couples with small families.
Birth Control/Contraception Features of an ideal contraceptive: User-friendly Easily available Effective Reversible No/least side-effects No interference with libido or act of coitus Two principle methods of birth control: Natural methods Artificial methods
Natural/Traditional Methods Based on the principle of avoiding physical meeting of the egg and sperms. Population Stabilisation Chances of failure are high. According to 2001 census, our population growth rate was around 1.7 per cent – 17/1000/year. Method Mode of Action Year Periodic abstinence Couples abstain from coitus from 1900 1947 2000 2011 day 10 to 17 of the menstrual cycle POPn i.e., fertile period. World 2 billion 6 billion 7.2 billion India approx: close to crossed Withdrawal method/ Insemination is avoided as the male 350 million 1 billion 1.2 billion Coitus interruptus partner withdraws his penis from the vagina just prior to ejaculation. Reasons for Increase in Population Size: Decline in death rate Lactational amenorrhea Absence of menstruation upto 6 months during period of intense Rapid decline in maternal mortality rate (MMR) lactation following parturition. Decrease in infant mortality rate (IMR) Artificial Methods Used by female only. Barrier methods II. Spermicidal Jellies, Foams and Creams Spermicidal jellies IUDs Kill the sperms by acidic pH. Oral pills Used along with barrier methods to increase their efficiency. Injections and implants Emergency contraceptives III. Intra-uterine devices (IUDs) Surgical methods Inserted by doctors or expert nurses in the uterus. I. Barrier Methods IUDs are one of the most widely accepted methods of Prevent ovum and sperm from physically meeting. contraception in India. (a) Condoms and its Types: Made up of rubber and latex sheath. Self-inserted and offer privacy to the user. Intrauterine devices
Parameter Males Females
Region covered Penis Vagina and cervix Non-medicated Copper-releasing Hormone-releasing Provides protection Yes Yes IUDs IUDs IUDs from STDs e.g., Lippes loop e.g., CuT, Cu7 Progestasert,
Male condom Multiload 375 LNG-20
(Nirodh) Female condom Mechanism of action of IUDs: They increase phagocytosis of sperms within the uterus and the (b) Diaphragms, cervical caps, vaults Cu ions released suppress sperm motility and the Rubber barriers that cover the cervix during coitus. fertilising capacity of sperms. The hormone-releasing Reusable. IUDs, in addition, make the uterus unsuitable for Do not protect from STDs. implantation and the cervix hostile to the sperms.
IV. Oral Contraceptive Pills (OCP) or Tablets
Parameter Non-steroidal Steroidal Example of Composition SAHELI (Centchroman) Progestogens alone or combination of progesterone and estrogens. Mode of action Interferes with implantation. Inhibit ovulation and implantation, also alter the quality of cervical mucus to retard entry of sperms. Dosage ‘Once a week’ pill. Pills have to be taken daily for a period of 21 days starting preferably within first 5 days of menstrual cycle Effectiveness High contraceptive value. Pills are very effective with lesser side effects and well accepted by females. Saheli was developed at CDRI, Lucknow, Uttar Pradesh
V. Implants Characteristics Placed under skin Effective within 72 hrs of coitus. Effective periods are much longer Used to prevent conception resulting from rape or unprotected Composition: Progestogens alone/Combination of intercourse. Progestogens and Estrogens VII. Surgical/Sterilization Methods Mode of Action Poor reversibility but highly effective Inhibit ovulation and implantation. Mode of action – Blocks gamete transport lter the quality of cervical mucus to retard entry of A sperms. Types
VI. Emergency Contraceptives Tubectomy Vasectomy
Types In females In males Progestogens alone Cut and tie fallopian tubes Cut and tie vas deferens Combination of Progestogen + Estrogen Incision in abdomen or Small incision on the scrotum through vagina IUDs
4 NEET (XII) Module-1 Zoology PW
Medical Termination Of Pregnancy (MTP)/Induced Category Disease Abortion Bacterial Gonorrhea, Syphilis, Chlamydiasis MTP: Intentional or voluntary termination of pregnancy Protozoan Trichomoniasis before full term. Genital herpes, Hepatitis-B, Genital warts, MTP was legalized in India in 1971. Viral AIDS 40–50 million MTPs are performed every year. Bacterial and protozoan diseases are completely curable if 1/5th of the total number of conceived pregnancies. detected early and treated properly. When can MTP be Performed? Symptoms and Complications of STDs Unwanted pregnancy due to rape, failure of contraception, casual unprotected intercourse. Early detection Late detection If continuation of pregnancy could harm the mother or foetus or both. Symptoms Complications Intention behind MTP amendment act 2017, (Government of Pelvic inflammatory diseases Itching, fluid discharge, India) slight pain, swellings in (PIDs), abortions, still births, Reducing the incidence of illegal abortion. the genital region ectopic pregnancies, infertility, cancer of reproductive tract Decrease consequent maternal mortality and morbidity. Mode of Transmission: MTPs are safe upto 12 weeks but riskier in 2nd trimester Sharing of injection needles, surgical instruments with yet both are legal. infected persons. Amniocentesis and MTPs have been misused in context Transfusion of blood. of female foeticide. From infected mother to foetus. Preventive measures to avoid STDs: Amniocentesis Avoid sex with unknown partners/multiple partners Analyse foetal cells and dissolved substances from amniotic Always try to use condoms during coitus fluids. Infertility Technique used to check for genetic disorders such as Down’s Unable to produce children inspite of unprotected sexual syndrome, sickle-cell anemia, etc. co-habitation. Statutory ban on this technique in India to prevent female Reasons: foeticide. Physical Diseases
tract infections (RTIs). Infertility as a problem could be with either the male or female partner. High vulnerability/risk group: 15-24 years. In India, female is blamed often than male for the couple Mode of transmission: Sexual intercourse. being childless.
Assisted Reproductive Technologies (ART)
Parameter In-vitro fertilization In-vivo fertilization Other details of ART involved: Site of fertilization Outside the body in In the female ICSI: Intra cytoplasmic sperm injection simulated conditions in reproductive tract Sperm injected directly into the egg laboratory Artificial Insemination (AI): Embryo transfer Yes No Semen introduced in vagina or uterus
Example of techniques ZIFT, IUT, ICSI GIFT, AI, IUI Low sperm count or inability of male to inseminate the female IUI: Intra uterine insemination
GIFT: Gamete intra fallopian transfer
Female can provide conditions for
fertilization and further development P W Reproductive Health 5 Site of Embryo Transfer (ET) based on number of blastomeres
Parameter Upto 8 blastomeres More than 8 blastomeres
Location In fallopain tube In uterus Technique ZIFT: Zygote Intra fallopian transfer IUT: Intra uterine transfer Test tube baby programme involves techniques with in-vitro fertilization.
